Chapter 30 Abdominal and Gentiurinary Injuries EMT

Falls

What is the most common MOI in geriatric patients

peritonitis may not develop for several hours

When a hollow organ is punctured during a penetrating injury to the abdomen:

guarding

When a patient stiffens the muscles of the abdomen, it is known as _______.

avoid speculation and document only factual data.

When documenting a call involving a female patient who was sexually assaulted, the EMT should:

Only when there is a complaint of severe pain or other injury

When should you visually inspect the external genitalia on your patient?

D. Injury to the kidneys usually indicates injury to other organs.

Which of the following is true regarding injury to the kidneys? A. Only minimal force is needed to damage the kidneys. B. Kidney injuries are rarely caused by blunt trauma. C. The kidneys are not well protected. D. Injury to the kidneys usually indicates injury to other organs.

urinary bladder

Which of the following organs is at MOST risk for injury as the result of a pelvic fracture?

liver

Which of the following organs would MOST likely bleed profusely when injured?

A. The protruding organs should be kept warm and moist.

Which of the following statements regarding abdominal eviscerations is correct? A. The protruding organs should be kept warm and moist. B. Most eviscerations occur to the left upper quadrant. C. Adherent material is preferred when covering an evisceration. D. The organs should be replaced carefully to avoid heat loss.

blunt force trauma

causes closed injuries results from an object striking the body without breaking the skin, such as being hit with a baseball bat or when the patient's body strikes the steering wheel during a motor vehicle crash

peritoneum as caustic digestive juices leak into the peritoneum

injury to the hollow organs of the abdomen may cause irritation and inflammation to the

keeping the injury moist and warm

management of esviceration injuries include

kidneys

may be difficult to detect because they are located in the well-protected region of the body.

urinary

most of the __ system lies behind the digestive tract

penetrating trauma

often a result of a gunshot wound or stab wound. other mechanisms of injury such as fall on an object can also cause __ to the abdomen

cativation

the temporary wound channel caused by high velocity weapons is called

are rarely-life threatening

Injuries to the external male genitalia _______.

lift the air bag and look for deformity to the steering wheel.

While assessing a 21-year-old female who struck a tree head-on with her small passenger car, you note that her air bag deployed. You should:

a poorly placed lap belt

Compression injuries to the abdomen that occur during a motor vehicle crash are typically the result of:

improperly placed lap belt

Compression injury is most likely due to which of the following?

diaphragm

Difficulty breathing and a sunken appearance of the anterior abdominal wall is MOST indicative of a ruptured:

hemorhage

damage to solid organs typically leads to

protrudes from an open injury to the abdomen (evisceration). keep the organ moist and warm. Cover the injury site with a large steril, moist, bulky dressing and an occlusive dressing

Never replace an organ that? how do you preserve an organ that is in this condition?

assume that the arrow injured an internal organ

A 20-year-old male was accidentally shot in the right upper abdominal quadrant with an arrow during an archery contest. Prior to your arrival, the patient removed the arrow. Your assessment reveals that he is conscious and alert with stable vital signs. The entrance wound is bleeding minimally and appears to be superficial. You should:

giving him small sips of plain water.

A 40-year-old male presents with severe abdominal pain following blunt trauma. He is diaphoretic, intensely thirsty, and has a weak and rapid pulse. Appropriate treatment for this patient includes all of the following, EXCEPT: covering him with a warm blanket. giving him small sips of plain water. promptly transporting to the hospital. administering supplemental oxygen.

applying direct pressure with a dry, sterile dressing.

A 54-year-old male experienced an avulsion to his penis when his foreskin got caught in the zipper of his pants. He was able to unzip his pants and remove the foreskin prior to your arrival. Your assessment reveals that he is in severe pain and that the avulsion is bleeding moderately. The MOST appropriate treatment for this patient includes:

Have you experienced recent abdominal trauma?

A 66-year-old male presents with dark red rectal bleeding and abdominal pain. He is conscious and alert; however, his skin is cool and clammy and his pulse is rapid. Further assessment reveals that his blood pressure is 112/60 mm Hg. Which of the following questions would be MOST pertinent to ask him?

a blunt injury to the kidney

A football player was struck by another player in the right flank area just below the posterior rib cage. He complains of severe pain and point tenderness to the area. Your assessment reveals that there is a small amount of blood in his underwear. You should be MOST suspicious for:

cover the exposed bowel with a moist sterile dressing and then secure it in place with a dry bandage.

A man has a large laceration across his lower abdominal wall and a loop of bowel is protruding from the wound. He is conscious and alert and there is minimal bleeding from the wound. You should:

hematuria

A sign of kidney damage following blunt trauma is:

infection

Abdominal pain, vomiting, and fever are most likely due to _______.

spleen

All of the following are hollow abdominal organs, EXCEPT the: A. bladder. B. spleen. C. ureters. D. stomach

apply direct pressure to the wound

An unresponsive trauma patient has a large open abdominal wound with massive external bleeding. You should:

prompt transport to the hospital is essential.

Because the depth of an open abdominal wound is often difficult to determine:

larger in proportion to the abdomen

In pediatric patients, the liver and spleen are _______.

may decrease the amount of blood that returns to the heart

Placing a pregnant patient in a supine position during the third trimester of pregnancy:

It is often discovered when the patient is jarred or moved suddenly.

Which of the following statements regarding rebound tenderness is correct? It should be assessed for by vigorously palpating the abdomen. Rebound tenderness is a specific sign found with a spleen injury. It is often discovered when the patient is jarred or moved suddenly. The absence of rebound tenderness rules out intra-abdominal injury.

Uterine trauma is likely to cause shock in the pregnant patient

Which of the following statements regarding trauma during pregnancy is correct? Uterine trauma in the pregnant patient rarely leads to severe bleeding. Uterine trauma is likely to cause shock in the pregnant patient. Uterine blood supply is greatly reduced during pregnancy. The uterus serves as a reservoir for blood supply during pregnancy

law enforcement is at the scene.

You are dispatched to a residence for a young female who was kicked in the abdomen. While en route to the scene, you should ask the dispatcher if:

insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a BVM

You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:

closely monitor him and reassess him frequently

You are transporting a patient with blunt abdominal trauma. The patient is unstable and is experiencing obvious signs and symptoms of shock. Your estimated time of arrival at the hospital is less than 10 minutes. After treating the patient appropriately, you should:

a hematoma in the flank region

You should suspect a kidney injury anytime the patient presents with _______.

be objective and factual

Your documentation on a sexual assault victim should _______.

control any external bleeding, administer oxygen, and transport at onc

Your presence is requested by law enforcement to assess a 33-year-old female who was sexually assaulted. The patient is conscious and obviously upset. As you are talking to her, you note an impressive amount of blood on her clothes in the groin area. Her blood pressure is 98/58 mm Hg, her pulse is 130 beats/min, and her respirations are 24 breaths/min. You should:

open (penetrating trauma) or closed (blunt trauma)

abdominal injures are caterogized as

internal bleeding

abdominal rigidity and periumbilical bruising are signs of

high index of suspicion

always maintain a ___ for serious intra-abdominal injury in the trauma patient, particularly in the patient who exhibits signs of shock

hollow or solid organ

either classification can result in injury to the___ of the abdomen and cause significant life-threatening bleeding